ABC of ADHD

Are children being over-diagnosed?

Paediatric neurologist Dr Richard Saul, argues in a new book that Attention Deficit Hyperactivity Disorder is wildly over-diagnosed and that thousands of children are being identified as victims and treated with drugs they do not need.

Instead, their behaviour is often a sign of simple, resolvable problems such as poor diet, lack of sleep, hearing loss, learning difficulties — even just old-fashioned boredom. He quotes the case of one boy whose inability to concentrate turned out to be caused by anaemia and a girl whose disruptive behaviour in class was down to extreme short-sightedness.

In other cases, the diagnosis of ADHD invariably masks something far more serious: depression, bipolar disorder, even schizophrenia. And because some of the symptoms of ADHD — irritability, listlessness, memory problems — are similar to those present in youngsters taking drugs or abusing alcohol, such harmful social habits are often allowed to take hold instead of being addressed.

As a parent, I know how tempting it is to become frustrated with a child’s behaviour and to look to the medical profession for answers. We’re all busy people: so much quicker and easier to give a problem a name and treat it with a handy little pill. But the first place any parent should head when a child starts to play up is not their doctor’s surgery, but the bathroom mirror.

Saul’s analysis presents us with an inconvenient truth. He is telling the mums and dads of children diagnosed with ADHD (of which there are approximately 400,000 in Britain) what many of them perhaps suspect, but don’t want to hear: the problems lie not with the children but with the paucity of their own parenting.

I do not exonerate myself from this accusation. As someone who never once contemplated giving up work after babies, I made many wrong decisions in the first few years of my children’s life. The upshot was that around the time my eldest started school, the most terrible realisation dawned on me: I hardly knew my children.

That, really, is the unspoken tragedy of the working mother. For all the financial and intellectual advantages we have by carrying on working, ours is also a story of benign neglect, of guilt, of children fighting for windows in our busy diaries — and of little ones left to their own (increasingly electrical) devices while we rush around frenetically, juggling priorities. This is all very different from my own upbringing. When I was a child, my father was out of the door first thing and often not home until past bedtime.

But it didn’t matter because my mother was my universe, the one constant in my life, a source of wisdom, discipline, advice, affection, fun. To this day she knows me better than I know myself. I am not sure I can say the same of myself in relation to my own children? They’re definitely always top of my to-do list; but there’s an awful lot else on there as well. Can I really blame them, then, when they exhibit attention-seeking behaviour?

When my son jumps all over the sofa in the evenings, knocking over the lampshade, does he have ADHD or is he just trying to get me to look up from my laptop? Is he ill or is he simply reacting to my parental incompetence?It’s a tough question that we all have to ask ourselves. Many parents, I imagine, find themselves in this kind of situation — and it’s not one that’s going to change in the near future.Not just because, increasingly, people need two incomes to keep their heads above the economic waterline, but also because, thanks to technology, many people no longer enjoy any such thing as a day off.

Last week, for example, I tried to take a few hours out to accompany my daughter on a school trip, only to be constantly distracted by a stream of work-related texts, emails and calls. Dr Saul may be right when he says ADHD is not a genuine illness. But the very fact of its existence is an inescapable symptom of one indisputable fact: the fragmentation of family life, by whatever means, is neither good for us nor our children.